Bartonella henselae is one of the most common zoonotic agents acquired from companion animals (cats) in industrialized countries. Nonetheless, although the prevalence of infections in cats is high, the number of human cases reported is relatively low. One hypothesis for this discrepancy is that B. henselae strains vary in their zoonotic potential. To test this hypothesis, we employed structured sampling to explore the population structure of B. henselae in the United Kingdom and to determine the distribution of strains associated with zoonotic disease within this structure. A total of 118 B. henselae strains were delineated into 12 sequence types (STs) using multilocus sequence typing. We observed that most (85%) of the zoonosis-associated strains belonged to only three genotypes, i.e., ST2, ST5, and ST8. Conversely, most (74%) of the feline isolates belonged to ST4, ST6, and ST7. The difference in host association of ST2, ST5, and ST8 (zoonosis associated) and ST6 (feline) was statistically significant (P < 0.05), indicating that a few, uncommon STs were responsible for the majority of symptomatic human infections.Bartonella henselae infections, manifesting most frequently as cat scratch disease (9), are one of the most common zoonoses acquired from companion animals in industrialized countries (15)(16)(17). In the reservoir host, the domestic cat, the prevalence of B. henselae bacteremia can exceed 40% (8), although it is usually somewhat lower in more temperate regions such as the United Kingdom, where the prevalence was found to be about 9% (6). Although the isolation of B. henselae from the blood of infected cats is straightforward, obtaining isolates from humans is difficult, and hence almost all human cases are diagnosed using serological or PCR-based approaches (1,10,11,15).Genetic diversity among B. henselae strains has been assessed using different genotypic methods (11,25,30), and all have delineated multiple genotypes (2-5, 7, 10, 15, 18, 20, 21). A study in the Netherlands, based on comparison of 16S rRNA gene sequences, provided the first evidence that B. henselae strains possessing a particular genotype were more frequently associated with zoonosis than others (5). Further support for this observation has resulted from the use of multilocus sequence typing (MLST) (1,15,20). The first application of MLST to B. henselae involved 37 feline and human isolates and identified seven sequence types (STs) that formed three deeprooted lineages, termed clonal complexes (CCs), within the species (15). The study revealed that human isolates were significantly overrepresented in one particular ST, ST1 (15). A subsequent survey of 182 B. henselae isolates acquired from archives around the world also found that ST1 was significantly associated with human infection and that, broadly, the geographical distribution of STs was not homogenous (1). However, in both MLST studies, the sampling of strains was not coordinated either geographically or temporally. Furthermore, the number of human-associated B. henselae isola...